# KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
- **Other names:** Interstate Medical Office Central
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1558812107
- **Legal business name:** KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
- **Authorized official:** STEPHEN SHAWN BARTON (EXECUTIVE DIRECTOR, REVENUE CYCLE)
- **Authorized official phone:** (503) 813-2440

## Contact information

- **Practice address:** 3600 N INTERSTATE AVE, PORTLAND, OR 97227-1106
- **Practice address phone:** (800) 813-2000
- **Practice address fax:** (503) 286-6879
- **Mailing address:** 500 NE MULTNOMAH ST, PORTLAND, OR 97232-2023
- **Mailing address phone:** (503) 813-2440
- **Mailing address fax:** (503) 813-2507

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/19/2016
- **Last updated:** 06/01/2021